Patient Counselling Flashcards
How should a patient be counseled on how to use a pessary? [5]
Wash hands before and after use.
Remove packaging before use.
Plunger of the applicator should be pulled out and the pessary placed in the opposite end of the applicator.
Patient should sit or lie down with knees bent and legs apart and should insert pessary as far as comfortable and then press plunger down to release the pessary into the vagina.
Advise patient that the pessary dissolves in the vagina and therefore they may prefer to wear a panty liner as some will leak out.
How should a patient on warfarin be counseled? [5]
Does the patient have an oral anticoagulant book?
Explain about NTW and need to take them exactly as prescribed.
Advise that when they see their doctor/dentist or buy OTC medicines they need to inform them that they are taking warfarin.
Explain about side effects they may experience such as increased bruising response or bleeding. If they cut themselves shaving it may take longer for the bleeding to stop.
Always refer to the PIL and Oral anticoagulant booklet.
What should a newly diagnosed diabetic taking metformin be informed of? [5]
- Importance of controlling blood sugar levels.
- How metformin works: reducing the amount of sugar being made and increases uptake of sugar out of blood into muscle.
- Identify if patient knows they should take it after food.
- Inform about side effects.
- Identify if the patient needs to change lifestyle and change habits.
What are the 12 steps to the safe and effective use of transdermal patches?
- Read the PIL
- Wash hands
- Select an area that is appropriate to apply the patch to, prepare the skin area and make sure the skin is clean and free of any powders, oils and lotions.
- Carefully open the packaging, if using scissors be careful not to cut the patch. Never use a patch that has been cut or damaged in any way.
- Remove the protective liner, do not touch the sticky side of the patch.
- Press down on the patch firmly with the palm of your hand.
- Make sure patch is properly attached, go around with finger.
- Throw away empty packaging.
- Wash hands.
- When it it time to remove patch, peel off slowly fold in half and place in bin.
- Wash your hands.
- Ask your doctor what to do if a patch loosens or falls off.
How should eye drops be instilled? [5]
- Wash hands and sit in front of mirror if needed.
- Bend head backwards and gently pull lower eyelid down.
- Hold dropper above the eye and squeeze one drop into the pocket.
- Let go of eyelid and keep eye closed for as long as possible with head tilted towards floor.
- Repeat as needed.
How should eye ointment be used? [4]
- Gently pull down your lower eyelid and look up.
- Hold the tube above eye and gently squeeze a 1 cm line of ointment along the inside of the pocket.
- Take care not to touch the eye or eyelashes with the tip of the applicator.
- Blink your eyes to spread the ointment over the surface of the eyeball.
How should a peak flow meter be used? [7]
- Move the marker to the bottom of the numbered scale.
- Stand up straight.
- Take a deep breath, fill your lungs all the way.
- Hold your breath and place mouthpiece in mouth. Close lips around it, do not place tongue against or inside the hole.
- Blow out as hard and fast as you can in a single blow, your first burst of air is the most important. So blowing for a longer time will not affect your result.
- Write down the number you get, but if you coughed or did not do the steps right, do not write down the number, instead repeat.
- Move the marker back to the bottom and repeat all these steps 2 more times. The highest of the 3 numbers is your peak flow number.
What should patients taking the following drugs be advised not to eat/drink? Amiodarone (Cordarone, Pacerone) Buspirone (Buspar) Carbamazepine (Tegretol) Cyclosporine (Gengraf, Neoral) Nifedipine (Procardia, Aldalat) Simvastatin (Zocor) Sirolimus (Rapamune) Tacrolimus (Prograf)
When taking any of these drugs, avoid:
Grapefruit juice
Fresh, canned, or frozen grapefruit
Drinks that contain grapefruit juice
How should ear drops be used properly? [10]
- Wash hands
- Gently clean ear with a damp cloth and then dry the ear.
- Warm the drops to near body temperature by holding the container in the palm of your hand.
- If the drops are a suspension, shake the bottle well for 10 seconds.
- Check the dropper tip to make sure that it is not chipped or cracked.
- Draw medication into dropper etc.
- Tilt head so that affected ear is up, or lie on your side. Pull the ear backward and upward to open ear canal.
- Place the correct number of drops in your ear. Gently press on the small skin flap over the ear to help the drops to run into the ear canal.
- Keep the ear titled up.
- Wash hands, put away medicine.
How should an inhaler be used? [10]
- Wash hands
- Remove cap and hold inhaler upright,
- Shake the inhaler.
- Breathe out slowly through your mouth.
- Hold your inhaler as shown by your doctor.
- While you are breathing in, press down on your inhaler one time to release the medication.
- Continue to breathe in slowly and as deeply as you can.
- Hold your breath for 10 seconds, if you can, to allow the medication to reach deeply into your lungs.
- Rinse mouth out with water
- Spit out the water, do not swallow.
How should nasal PUMP sprays be used?
- Wash hands thoroughly.
- Blow nose gently before using the spray
- Hold the bottle with your thumb at the bottom and the first two fingers at the top on either side of the nozzle. Prime the pump bottle by spraying it into the air a few times.
- Tilt your head slightly forward, gently insert the nozzle tip into one nostril. Press on the other side of your nose with one finger to close off the other nostril .
- Breathe in quickly while squeezing down on the pump bottle one time.
- Repeat as necessary.
- Do not blow your nose right after using the spray.
- Wash hands thoroughly after using the spray.
How should nasal sprays be used properly? [6]
- Wash hands properly
- Blow nose
- Insert bottle tip into nostril, press down on other nostril to close it off.
- Breathe in quickly while squeezing bottle.
- Repeat as needed.
- Wash hands etc.
How should nasal DROPS be used properly? [8]
- Blow nose
- Wash hands
- Check dropper tip is intact
- Avoid touching the dropper tip against your nose.
- Tilt your head back as far as possible, or lie down on your back on a flat surface (such as a bed) and hang your head over the edge.
- Place the correct number of drops into your nose.
- Clean dropper with warm water.
- Wash hands etc.
How should a rectal suppository be used? [11]
- Wash hands
- If it is soft, cool under running water to allow it to harden or place in fridge.
- Remove wrapper, if present.
- If approp cut the suppository in half.
- Put on a finger cot or disposable glove if desired.
- lubricate as appropriate,
- Lie on side with lower leg straightened out and upper leg bent forward toward stomach area.
- Lift upper buttock to expose rectal area,
- Insertion.
- Hold buttocks together for 5 minutes.
- Discard used materials and wash hands thoroughly.
How should nitroglycerin spray be used? [8]
- wash hands
- Pump must be sprayed 5 times before first use, and every 6 weeks thereafter.
- Hold bottle upright, do not shake, place forefinger on top of grooved button.
- Hold the bottle close to your mouth. Open mouth and bring the bottle in as close as possible.
- Press the button firmly with your forefinger to release the nitroglycerin lingual spray onto or under the tongue.
- DO NOT INHALE THE SPRAY.
- AVOID SWALLOWING IMMEDIATELY AFTER USE.
- No more than 3 metered sprays are recommended in 15 mins, seek medical help if pain relief does not occur.
